Peri-conception and first trimester diet modifies reproductive development in bulls.

Nutritional perturbation during gestation alters male reproductive development in rodents and sheep. In cattle both the developmental trajectory of the feto-placental unit and its response to dietary perturbations is dissimilar to that of these species. This study examined the effects of dietary protein perturbation during the peri-conception and first trimester periods upon reproductive development in bulls. Nulliparous heifers (n=360) were individually fed a high- or low-protein diet (HPeri and LPeri) from 60 days before conception. From 24 until 98 days post conception, half of each treatment group changed to the alternative post-conception high- or low-protein diet (HPost and LPost) yielding four treatment groups in a 2×2 factorial design. A subset of male fetuses (n=25) was excised at 98 days post conception and fetal testis development was assessed. Reproductive development of singleton male progeny (n=40) was assessed until slaughter at 598 days of age, when adult testicular cytology was evaluated. Low peri-conception diet delayed reproductive development: sperm quality was lowered during pubertal development with a concomitant delay in reaching puberty. These effects were subsequent to lower FSH concentrations at 330 and 438 days of age. In the fetus, the low peri-conception diet increased the proportion of seminiferous tubules and decreased blood vessel area in the testis, whereas low first trimester diet increased blood vessel number in the adult testis. We conclude that maternal dietary protein perturbation during conception and early gestation may alter male testis development and delay puberty in bulls.

Acute bleeding from pseudoaneurysms following liver and pancreatobiliary surgery.

PURPOSE: We report 12 patients with visceral PA following pancreato-biliary and hepatic surgery. RESULTS: Seven patients (7/11, 63 %) had developed postoperative complications from their original procedure; that information was missing in one patient. Bleeding occurred in eight (three with hemoperitoneum two with haemobilia, and three with GI bleeding through a biliary-enteric anastomosis), three were asymptomatic, and the other one presented with abdominal pain. Eleven patients had an interventional radiology procedure performed (Five underwent angioembolization, a stent was placed in four, and two patients underwent both procedures). Complications related to the procedure developed in 6 (54.5 %) patients, and surgery was required in four of them. CONCLUSION: Postoperative pseudoaneurysms (PA) of visceral arteries are rare and usually secondary to vascular injury after pancreato-biliary and liver surgery. They usually present with bleeding and nowadays most are amenable to initial control by interventional radiology.

Acute prostatitis probably due to Listeria monocytogenes in an HIV-infected patient.

We report a unique case of acute bacterial prostatitis probably caused by Listeria monocytogenes in an HIV-infected patient. For the best of our knowledge, this is the first case reported of a patient with this association. Our case illustrates the protean clinical presentations that L. monocytogenes infections may adopt, particularly in immunocompromised patients.

The role of surgery in the management of "body packers".

INTRODUCTION: The concealment of packets of illegal substances within body cavities is a common technique for drug smuggling worldwide. The goal of our study was to analyze the results of conservative treatment of "body packers", indications for surgical intervention, and postoperative morbidity. METHODS: This is a retrospective study of patients admitted to our hospital and diagnosed as body packers. The diagnostic protocol included an abdominal X-ray and urinalysis for toxic substances. Only patients with gastrointestinal symptoms, signs of intoxication, or a positive urinalysis were admitted for observation. Conservative management included bowel rest and serial abdominal radiographs to confirm the passage per rectum of all foreign bodies. Asymptomatic patients were given laxatives in the emergency department (ED) to promote bowel movements and were not admitted to the hospital. RESULTS: A total of 763 body packers were admitted to the hospital, all of whom were initially treated conservatively. Of these patients, 47 (6 %) developed complications: 28 with bowel obstruction, three with bowel perforation, and 16 with substance intoxication. In patients developing complications, urinalysis for toxic substances was negative in 19 (40 %). Sixteen (34 %) patients who developed complications were successfully managed nonoperatively. Three (6 %) other patients died before surgery: two deaths resulted from acute toxicity (one of them with an acute onset and a negative urinalysis) and the third patient died of bowel perforation. Laparotomy was required in 28 (3.5 %) body packers admitted for observation. Enterotomy and/or gastrotomy to remove the packets were the most frequently performed procedures. Postoperative morbidity occurred in 57 % of patients, with wound infection being the most frequent complication. CONCLUSIONS: Conservative management was effective in 94 % of symptomatic patients. A laparotomy was required in only 3.5 % of cases. The mortality rate in this series was low, resulting from either severe cocaine poisoning from ruptured packets or bowel perforation.

[Neurological complications in patients receiving solid organ transplants]. / Complicaciones neurológicas en trasplantados de órgano sólido.

INTRODUCTION: Neurological complications (NC) are a significant cause of morbidity and mortality in paediatric patients receiving solid organ transplants. Our aim was to describe the experience of our hospital with NC in paediatric patients receiving heart, lung and liver transplants. PATIENTS AND METHODS: A retrospective study was conducted on 140 paediatric patients who received a solid organ transplant during the period 2000-2011. RESULTS: A total of 23 paediatric solid organ transplant recipients (16.4% of cases), with a median age of 6 years, had NC. The symptoms were, in order of frequency: acute symptomatic seizures (12 patients); acute encephalopathy (11 patients); neuromuscular weakness (4 children), tremor (4 children), headache (2 children), neuropathic pain (2 children), and visual disturbances (2 children). The aetiologies of NC were: the neurotoxicity of the immunosuppressive drugs (12 patients), post-hypoxic-ischaemic encephalopathy (6 patients), infections (2 cases), mechanical compression of peripheral nerve during surgery (2 cases), and a metabolic complication (1 case). The five patients who met the criteria of posterior reversible encephalopathy syndrome had a favourable outcome. Seven patients died, four of them due to hypoxic-ischaemic encephalopathy. CONCLUSIONS: NC are common in paediatric patients receiving heart, liver, lung, and renal transplants, with acute symptomatic seizures and acute encephalopathy being the most common clinical signs. No differences were found in the NC with the different types of transplants. Neurotoxicity of the immunosuppressive drugs and hypoxic-ischaemic encephalopathy were the main causes of NC, having different management and outcomes. The prognosis was favourable in most of the patients, except for those who had moderate or severe post-hypoxic-ischaemic damage.

Effects of feeding management and time of day on the occurrence of self-suckling in dairy goats.

The occurrence of self-suckling was recorded in 21 dairy goats during periods of 20 minutes at three different times per day (immediately after milking and the first feed, immediately after the second feed and in the afternoon) for 27 days (divided into three experimental periods of nine days). As expected, negative associations between milk yield and the frequency of self-suckling were observed (P<0.05). Goats suckled on their own right teat more frequently than on the left teat. The width of the right teat (measured at the middle of the teat) was positively associated with the frequency of self-suckling after controlling for the width of the left teat. A higher self-suckling frequency was observed immediately after milking than in the other two periods of the day. The frequency of self-suckling by each goat was reduced when animals were supplemented ad libitum with wheat straw in addition to their ordinary feed.

[Risk factors involved in the need for blood transfusion in very low birth weight newborns treated with erythropoietin]. / Factores de riesgo implicados en la necesidad de transfusión sanguínea en recién nacidos de muy bajo peso tratados con eritropoyetina.

OBJECTIVE: To identify and quantify risk factors related to red blood cell transfusion in premature babies weighing<1,500g who received erythropoietin (EPO). Secondly, to assess the relationship between retinopathy of prematurity and rh-EPO. MATERIAL AND METHODS: Prospective descriptive study of infants admitted to the Reina Sofía University Hospital between January 2006 and March 2009. Infants reviewed had a birth weight<1,500g and gestational age<32 weeks. Infants were administered rh-EPO 750IU/kg/week subcutaneously 3 days/week/ 6 weeks. We used univariate and multivariate logistic regressions with PASW Statistics 18 for Windows. RESULTS: Data were obtained from 110 infants, with a mean birth weight of 1154grs and mean gestational age of 29.3 weeks. Risk factors (OR; 95% CI) for being transfused were: male sex (4.41; 1.24-15.66), GA (1.64; 1.14-2.36, 1 week), Hb level on admission (1.45; 1.04-2.04; 1g/dl), late onset sepsis (7.75; 2.21-21.11), late onset treatment with rh-EPO (6.27; 1.22-32.35). All surgically treated infants with patent ductus arteriosus ligation or necrotizing enterocolitis needed transfusion. There is no relationship between rh-EPO administration and retinopathy of prematurity (ROP), but there was a relationship with transfusion. CONCLUSIONS: Premature infants with the lower gestational age, being male, a lower Hb level on admission and late onset sepsis are those with the greatest risk for blood transfusion.

[Lower gastrointestinal bleeding secondary to rectal gastrointestinal stromal tumor]. / Hemorragia digestiva baja secundaria a tumor del estroma gastrointestinal rectal.

Gastrointestinal stromal tumors are the most frequent mesenchymal digestive tract neoplasms, but represent only 1 to3% of all GI tract neoplasms. We report an uncommon case of stromal rectal tumor because of its atypical location.

[Endoscopic techniques in bronchogenic carcinoma. Changes in recent decades]. / Técnicas endoscópicas en carcinoma broncogénico. Cambios en las últimas décadas.

A 57-year old woman with arterial hypertension under treatment. She has smoked since she was 18 years old with an accumulated index of 70 years/pack. She was studied in our Respiratory Department due to constitutional syndrome, the X-ray showing an image of focal pulmonary lesion in the right upper lobe of more than 3cm of peripheral location. The computed tomography (CT) scan confirmed the existence of a 3.3cm mass in the upper right lobe and detected paratracheal and subcarinal mediastinal abnormal lymph nodes. A subsequent Positron Emission Tomography (PET) confirmed pathological uptake of the mass and both lymph node locations. Which additional studies do you consider to be indicated for a correct diagnosis and mediastinal staging? Do bronchoscopy techniques alone establish the final diagnosis and staging of this patient?

La técnica de relajación sugestiva breve automatizada: ampliación del estudio de su eficacia a una muestra de universitarios / Automated Suggestive Brief Relaxation Technique: A widening study of its effectiveness in a university sample

Estudiamos la eficacia de la Técnica de Relajación Sugestiva Breve Automatizada integrada en AIRE, un programa cognitivo conductual para dejar de fumar, en un diseño de dos grupos (control GC y experimental GE) con medidas pre/post. La variable independiente tomó dos valores: relajación y reposo. Los efectos se evaluaron en dos variables dependientes: ansiedad estado (AE) y frecuencia cardiaca (FC). Los participantes fueron 138 estudiantes universitarios, de 21,29 años de media, 79,7% mujeres. Se hallaron diferencias significativas en AE pero no en FC comparando GE y GC. Hubo una reducción significativa pre/post en ambas variables dependientes tanto en el GE como en el GC, siendo menores en este último. Un mayor número de personas bajo la condición de relajación frente a la de reposo obtuvieron resultados beneficiosos. Concluimos que la técnica automática de Relajación Breve Sugestiva es eficaz a la hora de reducir el estado de ansiedad (AU)

To investigate the effectiveness of the Automated Suggestive Brief Relaxation of AIRE (a cognitive behavioural approach for smoking cessation) we conducted a study on two groups: control (CG) and experimental (EG), with pre/post measures. The independent variable had two values: rest and relaxation. In order to assess the main effects we used two dependent variables: state anxiety (SA) and heart rate (HR). Participants were 138 undergraduate students, with an average age of 21.29 years, and 79,7% women. Significant differences were found in SA but not in HR between EG and CG. There was a significant reduction in both pre/post dependent variables in both the EG and CG, though less in the latter. A larger number of participants obtained greater benefits under the relaxation versus the resting condition. We conclude that the Automated Brief Relaxation technique is efficacious for reducing state anxiety (AU)

NMR structural studies of oligosaccharides related to cancer processes.

A summary of spectroscopic methods for structural and conformational elucidation of bioactive carbohydrates based on nuclear magnetic resonance (NMR) is described. The formation of carbohydrate-protein complexes is often the initial step of biological responses. Therefore, knowledge about the structural factors that stabilize the complex may be relevant and contribute to predict the structural/conformational requirements of new drugs acting as agonists. Two examples of medical significance in the cancer research field are discussed (1) conformational studies of glycoconjugates related to antitumour vaccines (2) conformational analysis of glycosaminoglycans and the interaction heparin-fibroblast growth factor (FGF).

[Severe hypophosphataemia after starting parenteral nutrition in a patient with an intestinal fistula]. / Hipofosfatemia grave tras el inicio de nutrición parenteral en una paciente con fístula intestinal.

Hypophosphataemia is a complication that may appear in undernourished patients who are given nutrition by either enteral or parenteral means. It is associated with several clinical manifestations, including cardiological, neurological and haematological conditions of note, and may potentially be even life-threatening. It is therefore mandatory to ensure prevention and follow-up in those patients at risk of suffering this condition, taking into account the considerable morbidity and mortality associated with it.